Stories & Insights

Helping a Healthcare Payer Meet Its Commitment Using Agile Methodologies

Trexin assessed a complex program with a seemingly impossible deadline, developed a radically different approach for delivery, and allowed our Client to meet its commitment in record time.

Business Driver

Our Client, a leading Healthcare Payer, was competing for a very large State contract to provide Medicaid services under an innovative set of rules and benefits. Although previous implementations of similar size required more than a year to complete before the first claims could be processed, our Client asserted that they could be ready to enroll new members and to receive/process claims within five months. The State awarded our Client with the contact, in part because of the accelerated implementation timeline, backed by a commitment made directly to the State’s Governor who had invested considerable political capital to get the plan approved and viewed this program to be a part of his legacy. If delivery slipped, the plan would be at risk of being repealed, which would reflect poorly on the Governor and our Client. But initial planning exercises showed no path to meet the unprecedented pace required to satisfy the requirements, so Trexin was asked to help.

Approach

To ensure that we fully understood the complexities of the large implementation program already in progress, we conducted an intensive two-week assessment including interviews, workshops, and solution sessions with key stakeholders and delivery personnel. Sensing immediately that a radically different approach would be required to meet the timeline, Trexin began applying lean concepts staffed with dedicated, cross-functional and co-located teams working in an iterative and agile delivery model with immersed executive leadership.

The revised approach also included significant delivery support from a 3rd-party business process outsourcing provider. And Trexin recommended stripping away all non-essential program features and functions to focus everyone’s attention on the critical path.

Results

The pace of the program accelerated almost immediately after the first lean/agile practices were put in place. After only four months, our Client was able to accept membership enrollment requests and process claims for a completely new and innovative Medicaid program, fulfilling its commitment to the State and preserving its esteemed reputation. And the implementation was completed in 25% of the time required for previous programs of similar size, establishing a new benchmark for delivery execution and time-to-market effectiveness.

Our Client, an $8B global risk management and reinsurance firm, had one of its larger business units struggle to keep momentum through a massive technology migration from Windows XP to Windows 7, putting the migration timeline in jeopardy.